Surgical Management and Long-Term Follow-Up of Solid Pseudopapillary Tumor of Pancreas: A Large Series from a Single Institution

Cai, Yunqiang; Ran, Xun; Xie, Sheng‐Xue; Wang, Xin; Peng, Bing; Mai, Gang; Liu, Xuedong

doi:10.1007/s11605-014-2476-6

Cited by 48 publications

(58 citation statements)

References 24 publications

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“…This patient then presented with recurrent pancreatic head SPN and underwent a PD at a PSORC institution and had no recurrence after PD. Enucleation is a technique that can be used for SPN pathology in a subgroup of patients with the proper anatomic relations 22‐26 . A head of the pancreas mass is usually very close to the portal vein/SMV, bile duct, and pancreatic duct; therefore, successful enucleation with a negative margin may not be possible.…”

Section: Discussionmentioning

confidence: 99%

Pancreaticoduodenectomy for the treatment of pancreatic neoplasms in children: A Pediatric Surgical Oncology Research Collaborative study

Vasudevan

Zhu

et al. 2020

Pediatric Blood & Cancer

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Background To better characterize short‐term and long‐term outcomes in children with pancreatic tumors treated with pancreaticoduodenectomy (PD). Methods Patients 21 years of age or younger who underwent PD at Pediatric Surgical Oncology Collaborative (PSORC) hospitals between 1990 and 2017 were identified. Demographic, clinical information, and outcomes (operative complications, long‐term pancreatic function, recurrence, and survival) were collected. Results Sixty‐five patients from 18 institutions with a median age of 13 years (4 months‐22 years) and a median (IQR) follow‐up of 2.8 (4.3) years were analyzed. Solid pseudopapillary tumor of the pancreas (SPN) was the most common histology. Postoperative complications included pancreatic leak in 14% (n = 9), delayed gastric emptying in 9% (n = 6), marginal ulcer in one patient, and perioperative (30‐day) death due to hepatic failure in one patient. Pancreatic insufficiency was observed in 32% (n = 21) of patients, with 23%, 3%, and 6% with exocrine, or endocrine insufficiencies, or both, respectively. Children with SPN and benign neoplasms all survived. Overall, there were 14 (22%) recurrences and 11 deaths (17%). Univariate analysis revealed non‐SPN malignant tumor diagnosis, preoperative vascular involvement, intraoperative transfusion requirement, pathologic vascular invasion, positive margins, and need for neoadjuvant chemotherapy as risk factors for recurrence and poor survival. Multivariate analysis only revealed pathologic vascular invasion as a risk factor for recurrence and poor survival. Conclusion This is the largest series of pediatric PD patients. PD is curative for SPN and benign neoplasms. Pancreatic insufficiency is the most common postoperative complication. Outcome is primarily associated with histology.

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Section: Discussionmentioning

confidence: 99%

Pancreaticoduodenectomy for the treatment of pancreatic neoplasms in children: A Pediatric Surgical Oncology Research Collaborative study

Vasudevan

Zhu

et al. 2020

Pediatric Blood & Cancer

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“…23 However, complete, aggressive surgical resection should be performed for these neoplasms even in the presence of invasion into adjacent organs and distant metastases based on the prolonged survival after complete surgical resection. 24,25 Cheng and colleagues reported that en bloc synchronous portal vein-superior mesenteric vein or adjacent organ resection should be carried out to achieve a complete resection. 26 In our study, most patients who had pancreatic parenchyma infiltration or vascular invasion with R0 resection did not develop local recurrence or distant metastasis.…”

Section: Discussionmentioning

confidence: 99%

Solid Pseudopapillary Neoplasms of the Pancreas: a 19-Year Multicenter Experience in China

Cheng

et al. 2015

Journal of Gastrointestinal Surgery

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“…The biological behavior and prognosis of SPNs are still difficult to predict, and pancreatic SPN is still an enigma [14,15]. Surgery remains the mainstay of therapy [6,7,16], but selection of surgical approaches is still under debate. Some authors have advocated function-preserving surgical approaches [7,10], while others favor aggressive surgical resection [17] or have considered parenchymapreserving resection as a significant risk factor for tumor recurrence [8].…”

Section: Introductionmentioning

confidence: 99%

Surgical Management of Solid Pseudopapillary Neoplasms of Pancreas: A Single-Center Experience of 60 Patients

Lin

Lü

et al. 2020

Dig Surg

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Background: Solid pseudopapillary neoplasms (SPNs) of the pancreas are rare neoplasms, and the selection of surgical approaches is still under debate. The aim of this study was to analyze the clinicopathological characteristics and surgical outcomes of SPN patients and to compare the short-term and long-term outcomes between conventional operations and parenchyma-preserving operations. Methods: Patients who underwent pancreatic resection for SPNs between February 2010 and May 2019 in Fujian Medical University Union Hospital were identified. Clinicopathological details, perioperative data, and long-term follow-up results were retrospectively analyzed. Results: Sixty patients underwent surgical resection for SPNs during the study period: 48 females and 12 males. The mean age was 32.2 years. All patients underwent margin-negative surgical resection. The median follow-up period was 47 months (range: 3~118 months). One patient developed liver metastases 14 months after the operation and received local ablation therapy. All patients were alive during the follow-up. The incidence of postoperative pancreatic fistula was higher in the parenchyma-preserving surgery group than in the conventional surgery group (40.0 vs. 11.1%, p = 0.034). There was no significant difference in the tumor recurrence rate between the 2 groups. Eight (17.7%) and 6 patients (13.3%) in the conventional surgery group demonstrated endocrine and exocrine pancreatic insufficiency, respectively; furthermore, no patients in the parenchyma-preserving surgery group had endocrine or exocrine pancreatic insufficiency, but the incidences were not significantly different between the 2 groups. Conclusions: Margin-negative surgical resection of SPNs yields a very low rate of tumor recurrence and excellent long-term survival.

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Surgical Management and Long-Term Follow-Up of Solid Pseudopapillary Tumor of Pancreas: A Large Series from a Single Institution

Abstract: Complete resection of the tumor is associated with good survival, even in patients with vessel involvement or metastases. In patients with tumor recurrence, a second resection resulted in long-term survival.

Cited by 48 publications

References 24 publications

Pancreaticoduodenectomy for the treatment of pancreatic neoplasms in children: A Pediatric Surgical Oncology Research Collaborative study

Pancreaticoduodenectomy for the treatment of pancreatic neoplasms in children: A Pediatric Surgical Oncology Research Collaborative study

Solid Pseudopapillary Neoplasms of the Pancreas: a 19-Year Multicenter Experience in China

Surgical Management of Solid Pseudopapillary Neoplasms of Pancreas: A Single-Center Experience of 60 Patients

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